根据多排螺旋CT扫描数据确定颅脑创伤的机制:一个专家实践的案例

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在日常实践中,法医师解决准确确定伤害机制的问题,也是为了正确地着重刑事调查或初步检查的重点,以确定每个涉案人员的罪责。 每个嫌疑人在犯罪中的“贡献”有多大,相应地决定了对犯罪的责任有多大。在只有一个人涉嫌伤害他人身体的情况下,对于侦查机关来说,同样重要的是确定受害者哪些伤害是由该人直接造成的,而哪些只是在特定时间点上的各种情势的不幸的凑合。在这种情况下,对伤害机制问题的明确回答往往能使调查人员根据现行的《俄罗斯联邦刑事法》对嫌疑人的行为进行充分的评定。当涉及到对受害者、被告和其他人(活人)的鉴定时,情况变得复杂,因为与检查尸体相比,法医师没有机会详细检查 “原生材料”,而只限于医疗记录的数据、实验室和仪器测试的结果以及对被鉴定人的检查,这些通常是在事件发生很久之后由侦查机关提供的。

与标准放射照相相比,大脑多排螺旋CT的结果作为一种更准确的诊断方法,再加上对所提供案例材料的研究,使得在严重颅脑创伤的情况下可以逐次确定,总共形成颅脑创伤的 综合损伤,完全是由于撞击坚硬的钝物而跌倒造成的,从而限定了对撞击和反撞击区域的损害。

对该专家案例的分析证实了在法医学中使用现代放射诊断方法的重要性,特别是在确定颅脑损伤的机制方面。上述专家实践的案例证明了研究准确的放射诊断方法(在本案例中是多排螺旋CT)的结果和侦查机关提供的案例材料以确定颅脑创伤机制的重要性,特别是在对受害者、被告和其他人的鉴定中,这一点非常重要。

作者简介

Yulia B. Li

Moscow Regional Research and Clinical Institute; Primorsky Regional Bureau of Forensic Medical Examination

编辑信件的主要联系方式.
Email: reineerdeluft@gmail.com
ORCID iD: 0000-0001-7870-5746

Graduate Student correspondence

俄罗斯联邦, Moscow; Vladivostok

Marina V. Vishniakova

Moscow Regional Research and Clinical Institute

Email: cherridra@mail.ru
ORCID iD: 0000-0003-3838-636X
SPIN 代码: 1137-2991

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Vladimir A. Klevno

Moscow Regional Research and Clinical Institute

Email: vladimir.klevno@yandex.ru
ORCID iD: 0000-0001-5693-4054
SPIN 代码: 2015-6548

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

参考

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2. Fig. 1. Multispiral computed tomography of the brain: foci of contusion of the brain (arrows), in some places confluent, in the pole parts of the temporal lobe on the left in the axial section.

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3. Fig. 2. Multispiral computed tomography of the brain: foci of brain contusion in the pole-basal regions of the temporal lobe on the left (arrows) in the sagittal section.

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4. Fig. 3. Multispiral computed tomography of the brain: fracture of the pyramid of the right temporal bone with a transition to the posterior wall of the external auditory canal and hemorrhage into the cells of the mastoid process on the right, antrum, the tympanic cavity on the right (arrows) in the axial section.

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5. Fig. 4. Multispiral computed tomography of the brain: fracture of the pyramid of the right temporal bone with a transition to the posterior wall of the external auditory canal and hemorrhage into the cells of the mastoid process on the right, antrum, the tympanic cavity (arrows) on the right in the sagittal section.

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6. Fig. 5. Multispiral computed tomography of the brain: fracture of the mastoid process of the right temporal bone with transition to the posterior wall of the external auditory meatus (arrow) on the 3D-model.

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